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. . _ � t� �- - <br />� <br />� AP� 'CATION FOR RIrHT-OF-WAY USE PERMIT <br /> everen 1�0 0$ <br />, � <br /> � CITY ENGINEERS Z2 <br />� EVERETT,WASHINGTON PERMIT NO.�� <br />� TheUndersigned GAN�IG�S �-�� MQC1� ��' (�'�T _ 2' Ca.. 1 <br /> Hereby appiies for permission to Go}��ST 2• � �l 12.}_4 F r�p C k-�1 P <:O N�IEV OR '�S 1�c45 <br /> Ac�os� LIT� P(Z�P�.(�`C� — <br /> At the followinq location �-Ofl I - Z-CoTµ P�-- -- , <br /> � 1 _ <br /> SKETCH <br />� � (Work to be done) . <br /> No <br /> $Gq�E <br />' i <br />� ,�,���I N _ GI�IP �. SAwbusT ����2.�-}C-A.P <br /> � � conlv�.,oR. PIPES <br />� �:�1�a <br /> I I �,p� �To(�AGE <br /> i Pbs7 � R�NS <br /> � �y.Isr <br /> � Q�G <br /> 4coi 2��i-� p� . <br /> � oRIVEwAv SECTION The undersigned owner here6y a3rees to hold and <br /> NO SCALE save harmless the City of Everett from any and all <br /> . -_I.� ----- ,:�� claims for damages that may arise because of installa- <br /> � � —�1 tion and maintenance of the improvement hereto <br /> \ ��" L��- � I applied for and further agrees ro remove same upon <br /> � ������1__ _ __ I 30" notice from the City and ro replace public properry �, <br /> �lyy...T. -'1' <br /> damaged thereby. <br /> � ^� <br /> S�re o App icant � � <br /> _ 'L�O6( 2b�= �� <br /> - � -- --- . . - . . -. - . . .. r � Address <br /> '� COPI' OF TI-IIS APPUGfa'I IOhI �TO ��..� ' � <br /> � !'�E POSI�ED ON J0651TL '�, � � •�'� - �o �/ — <br /> � Telepho. Number <br /> c'.P.LLENGIPIEERING �EPT. 259�II3t11 �.. � ,� �r /��9, <br /> �` 116U1�� P,EFOHe COIdST^,UCTIQid�. <br /> Date c� � <br /> � N O �E�- <br /> . CHECK LIST Fee <br /> Water Valve ;i�� �� (, �� Lj p / p.l' Yals <br /> Drainage "} 7-l- 79- ^ °"/ � 7Q <br /> Curb&Gu[ter Engineers <br /> Sidewalk �r Water p � <br /> .� /� Street �� �/-� _���� <br /> /� i � � � . <br /> .,�� /a '� � -�y Communicatio s� � <br /> � , ' � <br /> --I spector'sSignature A�� ��v` T7affic_/�� �' '-�- _`� <br /> Plannin � i . <br /> ��r� � ��_ <br /> `pate <br /> � /:v ir'r �pU-f.'C/!. �`� 74 -- <br /> Remarks � _ _ �, <br /> Note: Original [o Customcr I� � <br /> 1 CopY ro File � � f �n ? ry// q roved b " � <br /> 1 Copy ro 1nsP�ctor ' �/�x p� �_�� <br /> , � �' i <br /> ��' 1 <br /> Date ApProved �j�j7� J <br /> i <br /> i <br /> � <br /> i <br /> Cr'_. <br /> J <br />